Provider Demographics
NPI:1134567472
Name:RENAISSANCE HEIGHTS LLC
Entity type:Organization
Organization Name:RENAISSANCE HEIGHTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMINICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BIOH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-866-5461
Mailing Address - Street 1:411 W 113TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-8074
Mailing Address - Country:US
Mailing Address - Phone:212-866-5461
Mailing Address - Fax:212-866-7706
Practice Address - Street 1:411 W 113TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-8074
Practice Address - Country:US
Practice Address - Phone:212-866-5461
Practice Address - Fax:212-866-7706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty